Financial Responsibility Acknowledgment

Forms and Documents

Document Name	Status
Form ATF Form 8620.28 Financial Responsibility Acknowledgment Form and Instruction	Modified
Executive Order 13764 1.17.2017.pdf Supplementary Document	2021-07-21
Executive Order 13467 7.2.2008.pdf Supplementary Document	2021-07-21
3 - Supporting Statement A - ATF F 8620.28 - 6-20-2024.docx Supporting Statement A	2024-09-11

IC Document Collections

IC ID	Document Title	Status
248470	Financial Responsibility Acknowledgment Form and Instruction	Modified

ICR Details

OMB Control No: 1140-0117	ICR Reference No: 202409-1140-002
Status: Received in OIRA	Previous ICR Reference No: 202107-1140-001
Agency/Subagency: DOJ/ATF	Agency Tracking No:
Title: Financial Responsibility Acknowledgment
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 09/25/2024

	Requested	Previously Approved
Expiration Date	36 Months From Approved	10/31/2024
Responses	2,000	2,000
Time Burden (Hours)	333	333
Cost Burden (Dollars)	2,000	2,000

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Abstract: The Financial Responsibility Acknowledgment (ATF F 8620.28) is used to determine if a candidate for federal or contractor employment at the Bureau of Alcohol, Tobacco, Firearms and Explosives is in compliance with federal regulations, which state that employees shall satisfy in good faith their obligations as citizens, including all just financial obligations. The previous name of this information collection was Financial History Questionnaire.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 58416	07/18/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 77894	09/24/2024
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Financial Responsibility Acknowledgment	ATF Form 8620.28	Financial Responsibility Acknowledgment

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	2,000	2,000	0	0	0	0
Annual Time Burden (Hours)	333	333	0	0	0	0
Annual Cost Burden (Dollars)	2,000	2,000	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/25/2024

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